Journal of Community Health

, Volume 41, Issue 4, pp 798–804 | Cite as

Regional Variation in Diabetic Outcomes by Country-of-Origin and Language in an Urban Safety Net Hospital

  • April K. Wilhelm
  • Debra J. Jacobson
  • Laura Guzman-Corrales
  • Chun Fan
  • Karen Baker
  • Jane W. Njeru
  • Mark L. Wieland
  • Deborah H. Boehm
Original Paper


Adherence to diabetic care guidelines among US immigrants remains low. This study assesses adherence to diabetic care guidelines by country-of-origin and language among a limited English-proficient (LEP) population. Timely completion of diabetic measures and acceptable levels of hemoglobin A1c (A1c), low density lipoprotein (LDL) cholesterol, and blood pressure (BP) were compared between LEP and English-proficient (EP) patients in this 2013 retrospective cohort study of adult diabetics. More LEP patients met BP targets (83 vs. 68 %, p < 0.0001) and obtained LDL targets (89 vs. 85 %, p = 0.0007); however, they had worse LDL control (57 vs. 62 %, p = 0.0011). Ethiopians and Somalians [adjusted OR (95 % CI) = 0.44 (0.30, 0.63)] were less likely than Latin Americans to meet BP goals. LEP patients outperformed EP peers on several diabetic outcomes measures with important variation between groups. These data highlight the success of a safety net hospital in improving diabetes management among diverse populations.


Diabetes Limited English language proficiency Immigrant Interpreter use 



This study was funded by the Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10900_2016_155_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • April K. Wilhelm
    • 1
  • Debra J. Jacobson
    • 2
  • Laura Guzman-Corrales
    • 3
  • Chun Fan
    • 2
  • Karen Baker
    • 4
  • Jane W. Njeru
    • 5
  • Mark L. Wieland
    • 5
  • Deborah H. Boehm
    • 3
  1. 1.United Family Medicine Residency ProgramSaint PaulUSA
  2. 2.Division of Biomedical Statistics and InformaticsMayo ClinicRochesterUSA
  3. 3.Minneapolis Medical Research FoundationMinneapolisUSA
  4. 4.Analytic Center of ExcellenceHennepin County Medical CenterMinneapolisUSA
  5. 5.Division of Primary Care Internal MedicineMayo ClinicRochesterUSA

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